<!-- 面板 -->
<div class="panel panel-default">
<div class="panel-heading"><p class="text-info">
    <span class="glyphicon glyphicon-star" aria-hidden="true"></span> 注册经纪人(必填)</p></div>
<div class="panel-body">
<!-- 面板内容 start -->

<form action="registJjr">
<!-- 表单START -->
<div id="form1" class="form-group">

<div class="input-group">
<div class="input-group-addon"><span class="glyphicon glyphicon-user" aria-hidden="true"></span></div>
<input name="name" type="text" class="form-control" id="exampleInputAmount" placeholder="姓名">
<div class="input-group-addon">
<span class="glyphicon glyphicon-remove-sign" aria-hidden="true"></span> 
<span class="glyphicon glyphicon-ok-sign" aria-hidden="true"></span>     
</div></div><!-- input-group-addon --><!-- input-group -->
   
    
<div class="input-group">
<div class="input-group-addon"><span class="glyphicon glyphicon-earphone" aria-hidden="true"></span></div>
<input name="phone" type="text" class="form-control" id="exampleInputAmount" placeholder="电话">
<div class="input-group-addon">
<span class="glyphicon glyphicon-plus-sign" aria-hidden="true"></span> 
<span class="glyphicon glyphicon-minus-sign" aria-hidden="true"></span>       
</div><!-- input-group-addon -->
</div><!-- input-group -->

<div class="input-group">
<div class="input-group-addon"><span class="glyphicon glyphicon-credit-card" aria-hidden="true"></span></div>
<input name="idcard" type="text" class="form-control" id="exampleInputAmount" placeholder="身份证号">
<div class="input-group-addon">
<span class="glyphicon glyphicon-plus-sign" aria-hidden="true"></span> 
<span class="glyphicon glyphicon-minus-sign" aria-hidden="true"></span>       
</div><!-- input-group-addon -->
</div><!-- input-group -->

<div class="input-group">
<div class="input-group-addon">省 <span class="glyphicon glyphicon-chevron-down" aria-hidden="true"></span></div>
<select class="form-control" id="S1" name="provinceId" >
</select>
<div class="input-group-addon">
<span class="glyphicon glyphicon-remove-sign" aria-hidden="true"></span> 
<span class="glyphicon glyphicon-ok-sign" aria-hidden="true"></span>       
</div><!-- input-group-addon -->
</div><!-- input-group -->

<div class="input-group">
<div class="input-group-addon">市 <span class="glyphicon glyphicon-chevron-down" aria-hidden="true"></span></div>
<select class="form-control" id="S2" name="provinceId">
</select>
<div class="input-group-addon">
<span class="glyphicon glyphicon-remove-sign" aria-hidden="true"></span> 
<span class="glyphicon glyphicon-ok-sign" aria-hidden="true"></span>       
</div><!-- input-group-addon -->
</div><!-- input-group -->

<div class="input-group">
<div class="input-group-addon">区 <span class="glyphicon glyphicon-chevron-down" aria-hidden="true"></span></div>
<select class="form-control" id="S3" name="provinceId">
</select>
<div class="input-group-addon">
<span class="glyphicon glyphicon-remove-sign" aria-hidden="true"></span> 
<span class="glyphicon glyphicon-ok-sign" aria-hidden="true"></span>       
</div><!-- input-group-addon -->
</div><!-- input-group -->



</div><!-- form-group -->   
<!-- 表单END -->
</form>

<!-- 面板内容  end  -->

<div class="panel-footer">
    <div class="row">
        <div class="col-xs-6"><button type="button" class="btn btn-warning">
            <span class="glyphicon glyphicon-arrow-left" aria-hidden="true"></span> 返回 </button>
        </div>
        <div class="col-xs-6"><button type="button" class="btn btn-warning">
            继续 <span class="glyphicon glyphicon-arrow-right" aria-hidden="true"></span></button>
        </div>
    </div>
</div>
</div>
</div>
